DisseminatedAcanthamoebainfection in a heart transplant recipient treated successfully with a miltefosine-containing regimen: Case report and review of the literature

Autor: Alexandra Hilts-Horeczko, Jana M. Ritter, Almea Matanock, Max N. Brondfield, Ibne Karim M. Ali, Rachel L. Rutishauser, Jennifer M. Babik, Michael J. A. Reid, Liviu Klein, Jevon Tang, Teresa DeMarco, Jennifer R. Cope, Sarah B Doernberg
Rok vydání: 2017
Předmět:
0301 basic medicine
Investigational
Biopsy
medicine.medical_treatment
Antibiotics
Flucytosine
Acanthamoeba
Polymerase Chain Reaction
Fluconazole
Skin
Heart transplantation
Drugs
Acanthamoeba infection
Immunosuppression
Amebiasis
Middle Aged
Metacarpal Bones
Magnetic Resonance Imaging
Anti-Bacterial Agents
Infectious Diseases
Female
Cardiomyopathies
miltefosine
Infection
6.4 Surgery
Immunosuppressive Agents
medicine.drug
medicine.medical_specialty
medicine.drug_class
Phosphorylcholine
Clinical Sciences
030106 microbiology
Article
Immunocompromised Host
03 medical and health sciences
Amphotericin B
Metronidazole
Internal medicine
medicine
Humans
Amebicides
Sinusitis
heart transplant
Antilymphocyte Serum
Transplantation
Miltefosine
business.industry
Evaluation of treatments and therapeutic interventions
Endoscopy
Drugs
Investigational
Organ Transplantation
medicine.disease
Surgery
Radiography
Regimen
Emerging Infectious Diseases
Heart Transplantation
business
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society, vol 19, iss 2
ISSN: 1398-2273
DOI: 10.1111/tid.12661
Popis: Disseminated acanthamoebiasis is a rare, often fatal, infection most commonly affecting immunocompromised patients. We report a case involving sinuses, skin, and bone in a 60-year-old woman 5months after heart transplantation. She improved with a combination of flucytosine, fluconazole, miltefosine, and decreased immunosuppression. To our knowledge, this is the first case of successfully treated disseminated acanthamoebiasis in a heart transplant recipient and only the second successful use of miltefosine for this infection among solid organ transplant recipients. Acanthamoeba infection should be considered in transplant recipients with evidence of skin, central nervous system, and sinus infections that are unresponsive to antibiotics. Miltefosine may represent an effective component of a multidrug therapeutic regimen for the treatment of this amoebic infection.
Databáze: OpenAIRE
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